Product description


SMA® PRO Anti-Reflux
dual action

Unique combination of easily digestible starch and 100% whey, partially hydrolysed protein.


Lowest protein anti-reflux formula in UK and Ireland, with 1.3 g of protein per 100 ml.1–5


2015 NICE guidelines recommend trial of a thickened formula in formula-fed infants with GOR.6

The first 1,000 days of a baby’s life have a life-long impact on many aspects of future health.

Gastro-oesophageal reflux (GOR) is a completely normal physiological process that affects approximately 40% of infants and usually resolves before they are 1 year old. 7

In their 2015 guideline, NICE recommend the following measures for the management of formula-fed infants with frequent regurgitation associated with marked distress: 7

  • Offer parental reassurance, review feeding history, suggest smaller more frequent feeds (while maintaining appropriate daily milk volume intakes)
  • Trial of a thickened formula
  • If the above stepped-care approach does not work, stop the thickened formula and offer alginate therapy for a trial period of 1–2 weeks

For information on suitability for use in Halal diets please contact the Careline on 0800 081 81 80 (UK) or 1800 931 832 (Ireland). 


PIP code (UK only): 286-7588
Supplier code (Ireland): 12328880

100% whey, partially hydrolysed protein
100% whey, partially hydrolysed protein

Although the mechanism of GOR is not fully understood, gastric emptying may play a role.8 Whey dominant formulas containing partially hydrolysed protein accelerate gastric emptying time making the formula easy to digest.9
The UK Department of Health also recognises that whey protein is easier to digest.10

Lowest protein anti-reflux formula* with 1.3 g of protein/100 ml1-5
Lowest protein anti-reflux formula* with 1.3 g of protein/100 ml1,2,4,5

A lower protein content formula has shown to provide growth rates more like a breastfed baby.11 This slower growth rate has shown to have significant long-term health benefits, including a lower risk of obesity, cardiovascular disease and diabetes.12

Thickened with potato starch
Thickened with potato starch

Starch thickener helps to reduce frequency and volume of regurgitation in infants.13,14

Starch is an appropriate thickener as it can be digested by the infant.

References Show all Hide all
  1. SMA® Anti-Reflux data card. Available at (accessed March 2019).

  2. Aptamil Anti-Reflux datacard (June 2018). Available at (accessed March 2019).

  3. Cow & Gate Anti-Reflux datacard. Available at (accessed March 2019).

  4. Hipp Organic Anti-Reflux datacard. Available at… (accessed March 2019).

  5. Enfamil AR datacard. Available at… (accessed March 2019).

  6. NICE (2015). Gastro-oesophageal reflux disease in children and young people. Available at (accessed March 2019).

  7. Fonkalsrud EW. Curr Probl Surg 1996; 33(1): 1–70.

  8. Billeaud C et al. Eur J Clin Nutr 1990; 44: 577–583.

  9. NHS. Types of formula milk (2016). Available at…. (accessed March 2019)

  10. Alexander et al., 2016. Growth of infants consuming whey-predominant term infant formulas with a protein content of 1.8 g/100 kcal: a multicenter pooled analysis of individual participant data. Am J Clin Nutr doi: 10.3945/ajcn.116.130633.

  11. Singhal A & Lucas A. Lancet 2004; 363: 1642–1645.

  12. Indrio F et al. J Pediatr and Neonatal Individualized Med 2015; 4(2).

  13. Toporovski M.S., Neufeld C.B., Cuflat C., Magni A.M., Aleixo D., Okana R.T. A comparative study among two different AR formulas and a standard formula in infants with gastroesophageal reflux (GER). (Abstract presented at the 46th Annual meeting of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition: London, May 8-11, 2013). JPGN 2013; Vol 56, Suppl 2:330.

* in UK and Ireland

® Registered Trademark


Anti Reflux 800
800 g powder

PIP code (UK only): 286-7588

Supplier code (Ireland): 12328880

SMA® Anti-Reflux contains easily digestible starch and 100% whey, partially hydrolysed protein and is the lowest protein anti-reflux formula in the UK and Ireland.1-4


Anti-Reflux Formulae SMA® Anti-Reflux1 Aptamil Anti-Reflux2 Cow & Gate Anti-Reflux2 Hipp Anti-Reflux3 Enfamil A R ('Anti-Reflux')4
Whey:casein 100:0 20:80 20:80 60:40 NS
Type of protein Partially hydrolysed Intact Intact Intact Intact
Protein content (g/100 ml) 1.3 1.6 1.6 1.4 1.72
Type of thickener Potato starch Carob bean gum Carob bean gum Carob bean gum Rice starch
Vegetarian No No No No No
Halal No* No No No No


For information on suitability for use in Halal diets please contact the Careline on 0800 081 81 80 (UK) or 1800 931 832 (Ireland). 
NS: Not stated

1. SMA® Anti-Reflux datacard. Currently available from SMA Nutrition UK & Ireland.
2. Aptamil Anti-Reflux and Cow & Gate Anti-Reflux datacards. Available at Accessed March 2019.
3. Hipp Organic anti-reflux datacard. Available at March 2019.
4. Enfamil AR datacard. Available at Accessed March 2019.

Please read these instructions carefully, as they are different to other baby formulae.

Information for you to give to parents

How to open and prepare your baby’s feed

Whilst this product is made under strict hygienic conditions, it is not sterile. Failure to follow instructions on preparation and storage may make your baby ill.


1. Pull the safety seal and open the lid. The scoop is provided under the lid. Lift the tab, pull on the foil seal, carefully and safely remove the seal and dispose of it.


2. Wash hands well. Wash and sterilise all utensils according to manufacturers' instructions.


3. Boil 1 litre of tap water. Allow to cool for no more than 30 minutes. Measure the required amount of water (see feeding guide) into a sterilised bottle, carefully – the water is hot. Do not use artificially softened or repeatedly boiled water.


4. Place the sterilised teat and cap on the bottle. Cool bottle under cold running water or in a bowl or jug of cold water until lukewarm, do not immerse the teat.


5. Using only the scoop provided, add the correct number of scoops of powder (see feeding guide), levelling off each scoop with the back of a clean, dry knife. Store the scoop in suspension inside the can and replace lid. 


6. Shake bottle well until powder has fully dissolved. Test temperature by shaking a few drops onto the inside of your wrist – milk should be lukewarm.

SMA® Anti-Reflux is a thicker formula that may require the use of a fast flow teat.

Information for you to give to parents

Feeding guide – powdered milk 800 g

Feeding guide birth – 12 months

Approx. age of baby

Approx. weight of baby

Preparation for single feeds

Feeds in 24 hours


Cooled, freshly boiled water



Level scoops


fl. oz. (approx.)

Birth – 2 weeks






2 – 4 weeks







4 – 8 weeks






2 months







3 months







4 months







6 months







7 – 12 months








This table is a guide only; a baby may need more or less than the volumes stated. Caregivers should consult their healthcare professionals if more advice is needed. Remember, a baby should be fed on demand. Mix 1 scoop of powder to 30 ml (approx. 1 fl. oz.) of water.

Approx. 182 scoops per can. 1 scoop = 4.4 g.

Information for you to give to parents

SMA® Anti-Reflux powder


Do not add extra powder or water to make feeds stronger or weaker and do not press powder into scoop. Using too much or too little powder can make your baby ill.


We recommend preparing each feed in individual bottles when required.


For hygienic reasons, discard unfinished feed in the bottle as soon as possible.


For older babies, made-up formulae can be added to food but not heated.


For enteral use only.


Do not use with other feed thickeners or antacids.


Do not alter or add to formulae unless medically directed.


Do not warm feeds in a microwave as it will cause milk to thicken, and hot spots may occur and cause scalding.


Remember, cows’ milk should not be used as a drink during the first year.

Find all relevant information on this product in our new healthcare professional leaflet:

Important Notice:

The World Health Organisation (WHO) has recommended that pregnant women and new mothers be informed on the benefits and superiority of breastfeeding – in particular the fact that it provides the best nutrition and protection from illness for babies. Mothers should be given guidance on the preparation for, and maintenance of, lactation, with special emphasis on the importance of a well-balanced diet both during pregnancy and after delivery. Unnecessary introduction of partial bottle-feeding or other foods and drinks should be discouraged since it will have a negative effect on breastfeeding. Similarly, mothers should be warned of the difficulty of reversing a decision not to breastfeed. Before advising a mother to use an infant formula, she should be advised of the social and financial implications of her decision: for example, if a baby is exclusively bottle-fed, more than one can (400 g) per week will be needed, so the family circumstances and costs should be kept in mind. Mothers should be reminded that breast milk is not only the best, but also the most economical food for babies. If a decision to use a formula is taken, it is important to give instruction on correct preparation methods, emphasising that unboiled water,  unsterilised bottles or incorrect dilution can all lead to illness. This product must be used under medical supervision. SMA® Anti-Reflux is a special formula intended for the dietary management of bottle-fed babies when significant reflux (regurgitation) is a problem. It is suitable as the sole source of nutrition up to 6 months of age, and in conjunction with solid food up to 12 months of age. If the baby’s reflux does not improve within 2 weeks of starting SMA® Anti-Reflux, or if the baby fails to thrive, the family doctor should be consulted.